THE World Health Organization is considering adding “gaming disorder” to the list of mental health conditions in its next update of the International Classification of Diseases (ICD).

The 11th version of the ICD is not yet set, but the addition would be a recognition that a pastime can become problematic if it leads to a form of addictive behavior.

Specifically, the draft’s language states that gaming behavior could be a disorder if it meets three characteristics: if a person loses control over their gaming habits, if they start to prioritize gaming over many other interests or activities, and if they continue playing despite clear negative consequences.

This would add gaming to a list of other behaviors that can become problematic if people lose control over them, including gambling and disorders related to the use of substances like alcohol, marijuana, caffeine or nicotine.

Gaming covers any activity from playing Two Dots on your iPhone to sitting down in front of a custom-built gaming PC for hours. Putting uncontrollable engagement in that category of activities on the list would give doctors and mental health professionals a way to officially diagnose someone with the condition.

But to be clear, this doesn’t mean that all gaming is addictive or could lead to a disorder. It’s only if the behavior is severe enough “to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning,” according to the draft. In other words, it has to be intense enough to harm personal relationships or interfere with school or work.

The psychology

of games

The psychological community has been debating whether gaming is addictive enough to be described as a disorder for some time. So far, the American Psychiatric Association has declined to classify gaming addiction as a disorder but has said it merits further research.

Part of the problem is how to distinguish between simply spending a lot of time playing games and actual addictive behavior.

Scientists need to “establish a clear-cut distinction between someone who may use games excessively but non-problematically and someone who is experiencing significant impairment in their daily life as a consequence of their excessive gaming,” a group of researchers from Nottingham Trent University in the U.K. wrote in a paper published last summer in the Journal of Addictive Behavior.

There are plenty of stories about individuals whose gaming behavior has become problematic — people have gotten so caught up in online games that they’ve ruined relationships and lost jobs. Compulsive gaming and substance abuse can also go hand in hand.

But problematic gaming may also serve as a dysfunctional coping mechanism for some, according to the Nottingham Trent researchers. Someone who is struggling with depression or anxiety may turn to gaming or substances like alcohol as a way to relieve those symptoms.

Benefits and harms

Figuring out the degree to which playing games is harmful (or helpful) is all about context, according to Bruce Lee, an associate professor of international health at the Johns Hopkins Bloomberg School of Public Health. Lee wrote in a column for Forbes that gaming habits can also be psychologically beneficial.

On the positive side, research has shown that game playing can relieve stress, improve problem-solving abilities, and enhance traits like hand-eye coordination. Technologies that we think of as for gaming, like virtual reality, can also be used in psychological therapy.

Yet people can struggle to find a healthy balance with gaming.

Researchers are still trying to understand the activity’s risks and effects, since it has only recently become such a common pastime — 63 percent of U.S. households contain at least one “frequent gamer,” a trait that didn’t exist a couple of generations ago.

Lots of countries are grappling with the issue and in South Korea the government has introduced a law banning access for children under 16 from online games between midnight and 6 a.m.

In Japan, players are alerted if they spend more than a certain amount of time each month playing games and in China, Internet giant Tencent has limited the hours that children can play its most popular games.